Abstract
To compare the outcomes of patients who had deep-lobe parotid gland pleomorphic adenomas (PAs) that extended into the parapharyngeal space after surgical treatment, using a transoral approach or an external approach. One hundred and twelve eligible patients, with deep-lobe parotid gland PAs, were enrolled in this retrospective study. The surgical outcomes were compared for patients who received a transoral approach and an external approach, using 1:1 propensity score matching (PSM). The outcome measures were recurrence rate, facial nerve deficit, Frey’s syndrome, and hospitalization time. The median follow-up time was 4.8 years. After PSM, the transoral approach and external approach groups had no statistically significant difference in recurrence (10.3% vs. 3.4%; p = 0.201). The transoral approach group had no facial nerve deficit, but 5 of 29 patients (17.2%) in the external approach group had transient facial nerve paralysis (p = 0.052). The external approach group had a longer hospitalization time than the transoral approach group (5 vs. 4 days, p = 0.0017). The use of a transoral surgical approach to treat patients with deep-lobe parotid gland PAs led to low recurrence, shorter hospitalization times, and good functional and cosmetic outcomes.
Highlights
Pleomorphic adenoma (PA) is the most common tumor of the parotid gland, and accounts for approximately 60 to 80% of all benign parotid gland tumors [1]
A PA located in the deep lobe usually extends into the parapharyngeal space (PPS) and presents as an asymptomatic mass that can be unnoticed for a long time
Some surgeons consider the transcervical approach as best for tumors originating from the deep lobe of the parotid gland [18]; some surgeons commonly use a transparotid approach for resecting deep-lobe parotid gland tumors, especially dumbbell-shaped lesions [19]; and some surgeons consider the transcervical–transparotid approach in patients with prestyloid tumors that have broad attachment to the deep lobe of the parotid gland [20]
Summary
Pleomorphic adenoma (PA) is the most common tumor of the parotid gland, and accounts for approximately 60 to 80% of all benign parotid gland tumors [1]. Surgeons may use a variety of approaches (transoral, transcervical, transcervical–transparotid, transparotid, and transmandibular) for thxe management of PPS tumors [4,5,6,7]. As the overall trend in surgery moves towards minimally invasive techniques, many surgeons favor a transoral approach, and there is evidence that transoral surgery, for the resection of benign lesions within the PPS, provides good results [8,9,10,11,12]
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